Glucose Monitoring

Helpful tip

To ensure the accuracy of your personal blood glucose monitor, take it to your physician's office to compare your results with the laboratory results. Also, it is important to keep a record of blood sugar levels, and other daily events that affect blood sugar levels, as this record will assist your doctor in making adjustments to your diabetes medication.

What is blood glucose monitoring?

Blood glucose levels (also called blood sugar levels) reflect how well diabetes is being controlled and how well the plan of care (diet, exercise, and medication) is working. If the blood sugar levels are consistently under control (with levels near normal), diabetes complications may be reduced or even prevented.

How can blood sugar levels be checked?

Checking blood glucose levels regularly is very important in proper diabetes management. Current methods of blood sugar monitoring require a blood sample. Blood sugar monitoring can be done at home with a variety of invasive devices to obtain the blood sample (invasive means the penetration of body tissue with a medical instrument).

Usually a drop of blood obtained through a finger prick is sufficient to use on a test strip that is then measured in a monitor. A finger prick can be done with a small lancet (special needle) or with a spring-loaded lancet device that punctures the fingertip quickly. The drop of blood is placed on a testing strip. The testing strip is then placed in a blood glucose monitor (also called a glucose meter or glucometer) which reads the blood sugar level.

Forget pricking the finger, wear a watch instead

Pricking the finger several times a day to monitor blood sugar levels is often a necessary task in the lives of many persons with diabetes. However, a new device that was recently approved by the FDA may make that painful prick a thing of the past.

Called the GlucoWatch Biographer, the device is a wristwatch that collects fluids from the skin through low electric currents to measure glucose levels. The watch monitors glucose levels every 20 minutes for 12 hours. If blood sugar levels fall too low or rise too high, the watch will sound an alarm.

The FDA has approved the GlucoWatch for limited use with the continued use of finger pricks for now. However, the device will reduce the number of times a person may have to use the finger prick method to test his or her blood sugar levels. (Experts currently recommend testing blood sugar levels between four and seven times a day in people with diabetes.) The FDA recommends confirming the GlucoWatch results several times a day with a finger prick test, because of the risk for error. The watch appears less effective in detecting very low glucose levels. The GlucoWatch is only available through prescription. Always consult your doctor for more information.

There are many types of monitors on the market today, ranging in price, ease of use, size, portability, and length of testing time. Each monitor requires its own type of testing strip. Blood glucose monitors have been found to be accurate and reliable if correctly used, and most monitors provide results within two minutes. Some glucose monitors can also give verbal testing instructions and verbal test results for people who are visually or physically impaired. There are also glucose monitors available that provide verbal instructions in Spanish and other languages.

Persons with diabetes may have to check their blood sugar levels up to four times a day. Blood sugar levels can be affected by several factors, including the following:

Diet

Diabetes medication

Exercise

Stress

Illness

Certain blood glucose monitors are equipped with data-management systems, which means your blood glucose measurement is automatically stored each time. Some doctor offices have computer systems compatible with these data-management systems, which allows the blood sugar level recordings, and other information, to be transferred electronically. One advantage of a data-management system is the ability to plot a graph on the computer depicting patterns of blood sugar levels.

What are noninvasive blood glucose monitors?

A finger prick can become painful and difficult for a person with diabetes to do on a regular basis. Several noninvasive devices (that do not require an actual blood sample) are currently being researched to provide persons with diabetes an alternative. However, most noninvasive blood glucose monitoring devices have not yet been approved by the FDA. Some noninvasive devices currently under investigation include:

The use of infrared light to shine through the forearm or finger

The use of low-level electrical currents to draw blood up through the skin

The use of saliva or tears to measure glucose levels

To ensure that monitors are approved for use, the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) suggests that consumers call the FDA at 888-INFO-FDA (463-6332). You can also check the FDA's website section titled "Blood Glucose Monitoring Devices."

What are healthy blood sugar level ranges?

Blood sugar levels over 200 mg/dL (mg/dL = milligrams of glucose per deciliter of blood) or under 70 mg/dL are considered unhealthy. High blood sugar levels (above 200 mg/dL) may be a sign of inadequate levels of insulin, caused by overeating, lack of exercise, or other factors. Low blood sugar levels (below 70 mg/dL) may be a caused by taking too much insulin, skipping or postponing a meal, over-exercising, excessive alcohol consumption, or other factors.

> 200 mg/dL

Too high; considered unhealthy

70 - 120 mg/dL

Good range

< 70 mg/dL

Too low; considered unhealthy

The American Diabetes Association (ADA) recommends a preprandial (before a meal) plasma glucose level of 70-130 mg/dl. The ADA has set the postprandial (after a meal) plasma glucose level of less than 18-mg/dl.

The following are the most common symptoms of hyperglycemia (high blood sugar). However, each individual may experience symptoms differently. Symptoms may include:

Rapid weight loss

Feeling sick

Intense thirst

Vomiting

Fatigue

Blurred vision

Fainting

The following are the most common symptoms of hypoglycemia (low blood sugar). However, each individual may experience symptoms differently. Symptoms may include:

Hunger

Fatigue

Shakiness

Headaches

Confusion

Dizziness

Sudden moodiness or behavior changes

Sweating

Pale skin color

Insurance and blood glucose monitoring:

Be sure to check with your insurance company to determine if blood glucose monitoring equipment and testing supplies are covered under your plan. If not, many suppliers offer rebates and/or discounted prices on trade-ins.

In addition, when selecting a glucose meter, the ADA reminds consumers to factor in the ongoing cost of test strips. Test strips can cost between 50 cents and one dollar per strip. Insurance providers vary on how many strips and how much of the test strip cost they will cover.